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machanical ventilation

Anna Miles, Naomi McLellan, Rochelle Machan, David Vokes, Alexandra Hunting, Mary McFarlane, Jennifer Holmes, Kelly Lynn
PURPOSE: Cardiothoracic surgery is known to result in dysphagia and laryngeal injury. While prevalence has been explored, extent, trajectory and longevity of symptoms are poorly understood. This retrospective, observational study explored dysphagia and laryngeal injury in patients following cardiothoracic surgery referred for instrumental swallowing assessment. METHODS: Clinical notes and endoscopic recordings of 106 patients (age range 18-87yrs; mean 63yrs; SD 15yrs) (including 190 endoscopes) at one large tertiary centre were reviewed by two speech-language pathologists and a laryngologist...
February 9, 2018: Journal of Critical Care
Laura Machan, Leonid Churilov, Raymond Hu, Philip Peyton, Chong Tan, Param Pillai, Louise Ellard, Ian Harley, David Story, Philip Hayward, George Matalanis, Nicholas Roubos, Sivendran Seevanayagam, Laurence Weinberg
OBJECTIVES: To compare the physiology of apneic oxygenation with low-tidal-volume (VT) ventilation during harvesting of the left internal mammary artery. DESIGN: Prospective, single-center, randomized trial. SETTING: Single-center teaching hospital. PARTICIPANTS: The study comprised 24 patients who underwent elective coronary artery bypass grafting surgery. INTERVENTIONS: Apneic oxygenation (apneic group: 12 participants) and low-VT ventilation (low-VT group: 12 participants) (2...
December 2017: Journal of Cardiothoracic and Vascular Anesthesia
Bryan Choi, Nicholas Asselin, Catherine C Pettit, Max Dannecker, Jason T Machan, Derek L Merck, Lisa H Merck, Selim Suner, Kenneth A Williams, Gregory D Jay, Leo Kobayashi
INTRODUCTION: Effective resuscitation of out-of-hospital cardiac arrest (OHCA) patients is challenging. Alternative resuscitative approaches using electromechanical adjuncts may improve provider performance. Investigators applied simulation to study the effect of an experimental automation-assisted, goal-directed OHCA management protocol on EMS providers' resuscitation performance relative to standard protocols and equipment. METHODS: Two-provider (emergency medical technicians (EMT)-B and EMT-I/C/P) teams were randomized to control or experimental group...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Sean F Monaghan, Charles A Adams, Andrew H Stephen, Michael D Connolly, Shea C Gregg, Jason T Machan, William G Cioffi, Daithi S Heffernan
BACKGROUND: Trauma produces profound inflammatory and immune responses. A second hit such as an infection further disrupts the inflammatory cascade. Inflammatory responses, following traumatic injuries, infections, or both, are emerging as biologic mediators of cardiac disease including myocardial ischemia and infarction. Inflammation-induced and stress-related cardiac damage are increasingly recognized in patients with critical illness. It is believed that cardiac dysfunction is the result of alterations in the inflammatory and immune cascades...
November 2012: Journal of Trauma and Acute Care Surgery
Nikola Dobrilovic, James G Fingleton, Andrew Maslow, Jason Machan, William Feng, Paula Casey, Frank W Sellke, Arun K Singh
OBJECTIVES: Redo cardiac surgery for aortic valve replacement (AVR) after previous coronary artery bypass grafting (CABG) is technically challenging and carries a high incidence of peri-operative complications. However, experience in the field continues to evolve generating reproducible, and increasingly safer results. We anticipate an increased future role for catheter-based valve procedures and review our operative results to maintain current surgical outcomes for comparison. METHODS: A retrospective review was conducted from 1996 through 2010 of patients undergoing AVR as a re-operation after previous CABG...
November 2012: European Journal of Cardio-thoracic Surgery
Andrew C Stone, Jason T Machan, Jeffery Mazer, Brian Casserly, James R Klinger
Pulmonary hypertension (PH) is associated with decreased overall survival in patients with chronic lung disease. The purpose of this study was to determine the effect of echocardiographic evidence of PH on 1-year survival in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (COPD). This is a retrospective study of patients admitted to a respiratory intermediate care unit with COPD exacerbation between October 1, 2002 and September 30, 2004. All patients who had 2D echocardiograms and pulmonary function tests done within 12 months prior to hospital admission or during the admission were examined...
June 2011: Lung
Anthony M Napoli, David P Milzman, Jennifer A Damergis, Jason Machan
OBJECTIVES: Previous analyses of physiologic parameter changes during ascent to altitude have incorporated small numbers of well-trained climbers. The effects of altitude illness are more likely to occur and may come to medical attention more frequently in unacclimatized recreational individuals. We sought to evaluate acute changes in physiologic parameters during ascent to high altitude (14,100 ft) in recreational climbers. METHODS: We performed a prospective naturalistic study of 221 recreational climbers at Mount Shasta (peak altitude of 14,162 ft)...
November 2009: American Journal of Emergency Medicine
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